Use of ciprofloxacin in neonatal sepsis: lack of adverse effects up to one year

Drossou-Agakidou, V; Roilides, Emmanuel; Papakyriakidou-Koliouska, Panagiota; Agakidis, Charalampos; Nikolaides, Nikolaos; Sarafidis, Kosmas; Kremenopoulos, George

doi:10.1097/00006454-200404000-00014

Cited by 39 publications

(28 citation statements)

References 24 publications

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“…Ciprofloxacin has a complex safety profile. A range of adverse drug reactions, including arthropathies, without identified long-term effects, need to be balanced with its efficacy (14)(15)(16). Potential neuroprotective effects were demonstrated in a juvenile animal model subjected to Escherichia coli sepsis (17).…”

Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetics of Ciprofloxacin in Neonates and Young Infants Less than Three Months of Age

Zhao

Hill

Guellec

et al. 2014

Antimicrob Agents Chemother

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Ciprofloxacin is used in neonates with suspected or documented Gram-negative serious infections. Currently, its use is off-label partly because of lack of pharmacokinetic studies. Within the FP7 EU project TINN (Treat Infection in NeoNates), our aim was to evaluate the population pharmacokinetics of ciprofloxacin in neonates and young infants <3 months of age and define the appropriate dose in order to optimize ciprofloxacin treatment in this vulnerable population. Blood samples were collected from neonates treated with ciprofloxacin and concentrations were quantified by high-pressure liquid chromatography-mass spectrometry. Population pharmacokinetic analysis was performed using NONMEM software. The data from 60 newborn infants (postmenstrual age [PMA] range, 24.9 to 47.9 weeks) were available for population pharmacokinetic analysis. A two-compartment model with first-order elimination showed the best fit with the data. A covariate analysis identified that gestational age, postnatal age, current weight, serum creatinine concentration, and use of inotropes had a significant impact on ciprofloxacin pharmacokinetics. Monte Carlo simulation demonstrated that 90% of hypothetical newborns with a PMA of <34 weeks treated with 7.5 mg/kg twice daily and 84% of newborns with a PMA >34 weeks and young infants receiving 12.5 mg/kg twice daily would reach the AUC/MIC target of 125, using the standard EUCAST MIC susceptibility breakpoint of 0.5 mg/liter. The associated risks of overdose for the proposed dosing regimen were <8%. The population pharmacokinetics of ciprofloxacin was evaluated in neonates and young infants <3 months old, and a dosing regimen was established based on simulation.

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Section: Discussionmentioning

confidence: 99%

Population Pharmacokinetics of Ciprofloxacin in Neonates and Young Infants Less than Three Months of Age

Zhao

Hill

Guellec

et al. 2014

Antimicrob Agents Chemother

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“…It also did not appear to be associated with clinical arthropathy or growth impairment at 1-year follow-up. 21 Ciprofloxacin has been seen to be independently protective against ESBL K. pneumoniae colonisation (OR 0.1, 95% CI 0.0-0.97), in contrast with vancomycin (OR 6.6, 95% CI 1.73-25.28), amphotericin B (OR 12.0, 95% CI 1.79-80.5) and metronidazole (OR 5.3, 95% CI 1.1-25.6). 22 Moreover, fluoroquinolones can also reduce the current dependence on carbapenem agents and limit the potential for further emergence of carbapenem resistance.…”

Section: Discussionmentioning

confidence: 99%

Extended-spectrum β lactamase-producing gram-negative bacteria: clinical profile and outcome in a neonatal intensive care unit

Sehgal

Gaind

Chellani

et al. 2007

Annals of Tropical Paediatrics

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“…One study involving 10 lactating women who were given ciprofloxacin in 3 doses every 12 h estimated that an infant fed only by breast would receive a maximum of 0.57 mg/kg daily dose of the drug. The dosage that an infant would receive is low compared to the levels used to treating newborn infants (10 to 40 mg/kg) [99][100][101][102] . Another study showed that an infant nursing from a woman being treated with ciprofloxacin for 10 d had no measurable ciprofloxacin in the infant's serum (< 30 μg/L) 2.7 h after breastfeeding [103] .…”

Section: Pregnancymentioning

confidence: 99%

Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

Hosseini‐Carroll¹,

Mutyala²,

Seth³

et al. 2015

WJGPT

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Manas K made critical revisions of the manuscript; Becker F and Alexander JS contributed equally as senior authors. Conflict-of-interest statement:There are no known conflicts of interest. The authors (Pegah Hosseini-Carroll, Monica Mutyala, Abhishek Seth, Shaheen Nageeb, Demiana Soliman, Moheb Boktor, Ankur Sheth, Jonathon Chapman, James Morris, Paul Jordan, Kenneth Manas, Felix Becker, and J Steven Alexander) have no relevant financial considerations related to this proposal, and the study was not supported by any corporate entity. There is no known intellectual property associated with this report. AbstractInflammatory bowel diseases (IBD) are chronic idiopathic inflammatory conditions characterized by relapsing and remitting episodes of inflammation which can affect several different regions of the gastrointestinal tract, but also shows extra-intestinal manifestations. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While IBD therapy has improved dramatically with enhanced surveillance and more abundant and powerful treatment options, IBD disease can have important effects on pregnancy and presents several challenges for maintaining optimal outcomes for mothers with IBD and the developing fetus/neonate. Women with IBD, the medical team treating them (both gastroenterologists and obstetricians/gynecologists) must often make highly complicated choices regarding conception, pregnancy, and post-natal care (particularly breastfeeding) related to their choice of treatment options at different phases of pregnancy as well as post-partum. This current review discusses current concerns and recommendations for pregnancy during 157November 6, 2015|Volume 6|Issue 4| WJGPT|www.wjgnet.com Hosseini-Carroll P et al . Pregnancy and inflammatory bowel diseases IBD and is intended for gastroenterologists, general practitioners and IBD patients intending to become, (or already) pregnant, and their families. We have addressed patterns of IBD inheritance, effects of IBD on fertility and conception (in both men and women), the effects of IBD disease activity on maintenance of pregnancy and outcomes, risks of diagnostic procedures during pregnancy and potential risks and complications associated with different classes of IBD therapeutics. We also have evaluated the clinical experience using "top-down" care with biologics, which is currently the standard care at our institution. Post-partum care and breastfeeding recommendations are also addressed. Core tip: Inflammatory bowel diseases (IBD) are chronic inflammatory conditions characterized by relapsing and remitting episodes of intestinal inflammation. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While therapies have improved dramatically, IBDs have important effects on pregnancy and present challenges for maintaining optimal outcomes for mothers and their developing fetus/ neonate. Women with IBD and physician...

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Use of ciprofloxacin in neonatal sepsis: lack of adverse effects up to one year

Abstract: Treatment of neonatal sepsis with ciprofloxacin resulted in no short term hematologic, renal or hepatic adverse effects and did not appear to be associated with clinical arthropathy or growth impairment at 1 year follow-up evaluation.

Cited by 39 publications

References 24 publications

Population Pharmacokinetics of Ciprofloxacin in Neonates and Young Infants Less than Three Months of Age

Population Pharmacokinetics of Ciprofloxacin in Neonates and Young Infants Less than Three Months of Age

Extended-spectrum β lactamase-producing gram-negative bacteria: clinical profile and outcome in a neonatal intensive care unit

Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management

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